Current diagnostic tests, including digital rectal exams (DRE), serum prostate specific antigen (PSA) and trans-rectal ultrasound (TRUS) guided biopsy, do not provide the information needed to confidently diagnose and manage prostate cancer (PCa) in an optimized, cost effective way. Serum PSA has low specificity, and random TRUS guided biopsy can result in underestimation of the presence, extent and grade of PCa. Uncertainty regarding the accurate assessment of grade and disease extent, particularly for men with apparent low-risk disease has limited the adoption of active surveillance despite the fact that it is considered by many to be the preferred initial management strategy for these men. This limitation has contributed to the significant overtreatment of prostate cancer with high costs to the healthcare system, and increased morbidity resulting in lower quality of life for many men.